Tigecycline (TIG) stands as a pivotal third-generation tetracycline within the glycylcycline antibiotic class, offering a crucial lifeline in addressing severe human infections attributed to multidrug-resistant Gram-positive and Gram-negative bacteria. Its deployment as a last-resort treatment against strains resistant to carbapenems and colistin underscores its highest-priority status in critical healthcare scenarios. While first- and second-generation tetracyclines like oxytetracycline, chlortetracycline, doxycycline, and minocycline have found extensive use in human and animal healthcare, and as environmental biocides globally, TIG remains unutilized in these settings. Unfortunately, the inappropriate utilization of older tetracyclines alongside the increasing reliance on TIG in human medicine has spurred the emergence of TIG-resistant bacterial strains.
The misuse of tetracyclines, particularly rampant in low- and middle-income countries where over-the-counter availability prevails, has led to bacterial mutations resulting in tetracycline resistance, often accompanied by low- to moderate-level TIG resistance. Additionally, plasmid-mediated resistance mechanisms—such as tet(X) flavin monoxygenases, TmexCD-toprJ efflux pumps, and plasmid-borne resistance genes like tet(A) and tet(L)—are rendering TIG ineffective in clinical applications.
Understanding these evolving mechanisms of tigecycline resistance remains a pressing challenge. Presently, diagnostic methods for detecting TIG resistance rely on phenotypic techniques like disc diffusion and broth microdilution, while whole genome sequencing aids in identifying TIG resistance genes. Alarming rates of phenotypic TIG resistance and the corresponding genes are surging globally within the One Health triad (human, animal, and environment), especially in low- and middle-income regions, which could potentially serve as hotspots for the proliferation of TIG resistance. TIG-resistant bacteria, often multi- to pandrug-resistant, pose significant therapeutic challenges due to their resistance to most available antibiotics.
Consequently, the limited treatment options against these superbugs hinder effective therapy and impede the promising repurposing of tetracyclines for human use. This establishes TIG-resistant bacteria as top-priority pathogens, necessitating enhanced surveillance and innovative therapeutic approaches.
The primary objective of this research collection is to delve into the epidemiology, phenotypic and genomic traits of TIG-resistant organisms, alongside exploring diagnostic, treatment, and prevention strategies. Unravelling the mechanisms and potential risk factors for TIG resistance and the exploration of novel therapeutic avenues remain crucial in combating the escalating threat of these superbugs. Collating multidisciplinary research endeavours in this collection will significantly contribute to our comprehension of TIG resistance. This understanding is vital for formulating evidence-based multidisciplinary approaches, informing policy decisions, preventing the spread of TIG-resistant bacteria in healthcare settings and communities, preserving effective antibiotic treatments, enhancing patient safety and health outcomes, and salvaging the therapeutic value of tetracycline antibiotics.
Keywords:
threat, health, mobile tigecycline resistance, overuse, antimicrobial resistance, tigecycline clinical effectiveness, TIG, tetracycline
Important Note:
All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
Tigecycline (TIG) stands as a pivotal third-generation tetracycline within the glycylcycline antibiotic class, offering a crucial lifeline in addressing severe human infections attributed to multidrug-resistant Gram-positive and Gram-negative bacteria. Its deployment as a last-resort treatment against strains resistant to carbapenems and colistin underscores its highest-priority status in critical healthcare scenarios. While first- and second-generation tetracyclines like oxytetracycline, chlortetracycline, doxycycline, and minocycline have found extensive use in human and animal healthcare, and as environmental biocides globally, TIG remains unutilized in these settings. Unfortunately, the inappropriate utilization of older tetracyclines alongside the increasing reliance on TIG in human medicine has spurred the emergence of TIG-resistant bacterial strains.
The misuse of tetracyclines, particularly rampant in low- and middle-income countries where over-the-counter availability prevails, has led to bacterial mutations resulting in tetracycline resistance, often accompanied by low- to moderate-level TIG resistance. Additionally, plasmid-mediated resistance mechanisms—such as tet(X) flavin monoxygenases, TmexCD-toprJ efflux pumps, and plasmid-borne resistance genes like tet(A) and tet(L)—are rendering TIG ineffective in clinical applications.
Understanding these evolving mechanisms of tigecycline resistance remains a pressing challenge. Presently, diagnostic methods for detecting TIG resistance rely on phenotypic techniques like disc diffusion and broth microdilution, while whole genome sequencing aids in identifying TIG resistance genes. Alarming rates of phenotypic TIG resistance and the corresponding genes are surging globally within the One Health triad (human, animal, and environment), especially in low- and middle-income regions, which could potentially serve as hotspots for the proliferation of TIG resistance. TIG-resistant bacteria, often multi- to pandrug-resistant, pose significant therapeutic challenges due to their resistance to most available antibiotics.
Consequently, the limited treatment options against these superbugs hinder effective therapy and impede the promising repurposing of tetracyclines for human use. This establishes TIG-resistant bacteria as top-priority pathogens, necessitating enhanced surveillance and innovative therapeutic approaches.
The primary objective of this research collection is to delve into the epidemiology, phenotypic and genomic traits of TIG-resistant organisms, alongside exploring diagnostic, treatment, and prevention strategies. Unravelling the mechanisms and potential risk factors for TIG resistance and the exploration of novel therapeutic avenues remain crucial in combating the escalating threat of these superbugs. Collating multidisciplinary research endeavours in this collection will significantly contribute to our comprehension of TIG resistance. This understanding is vital for formulating evidence-based multidisciplinary approaches, informing policy decisions, preventing the spread of TIG-resistant bacteria in healthcare settings and communities, preserving effective antibiotic treatments, enhancing patient safety and health outcomes, and salvaging the therapeutic value of tetracycline antibiotics.
Keywords:
threat, health, mobile tigecycline resistance, overuse, antimicrobial resistance, tigecycline clinical effectiveness, TIG, tetracycline
Important Note:
All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.